Therapeutic Breathing Techniques Used to Heal Disease

By Sussanna Czeranko, ND 

Being sick is no fun. When we are unhealthy, we are constantly aware of our discomfort. When we get sick, getting the right treatment is as important as knowing what is wrong. However, if we are sick and we know that we are sick, it does not help to be told that our lab tests haven't indicated any signs of disease or serious health problems. It is frustrating to not feel well and not know where to turn to get better. 

We live at a time when technology dominates every part of our lives (including health and medicine) with increasing sophistication and expense. New machines and new super drugs inundate the landscape of healthcare. Indeed, much has been said about the shortcomings of our medical system. Its focus on disease and the impact of pharmaceutical and surgical side effects, as opposed to prevention, natural therapies and long term wellness, is such that many increasingly choose alternative approaches to get their health needs met. One such choice is healthy breathing.

One doesn't have to be a scientist to know that healthy breathing is important. Just talk to someone who has suffered an asthmatic episode. Breathing "right" makes all the difference to your health and a therapy called Buteyko Breathing, originating in Russia 50 years ago, can help you to do just that.  

Buteyko Breathing is the culmination of a lifetime of research and study by Russian medical scientist, Dr. Konstantin Buteyko, (1923-2003). Dr Buteyko was a true pioneer. He formulated breathing exercises that restore and retrain our breathing to a healthy pattern. His observations on respiratory functions parallel standard mainstream medicine and he used the same medical
paradigms to substantiate his methods and clinical outcomes. His colleagues did not initially accept his breathing theories and methods. In fact, as is often the case with pioneers, he was ridiculed and vilified by his peers. After years of perseverance, he lived to witness his breathing training officially recognized by the Russian government. It is on record that over 100,000 people benefited from his breathing therapy.

The interesting thing about Dr Buteyko is that he did not invent a new law or principle governing respiration or human physiology. Rather, Dr. Buteyko used existing data and theory commonly found in standard medical physiology texts and applied the information to create the basis of his therapy. Buteyko turned everything we knew about breathing upside down and inside out. People under stress or exposed to a stressful trigger, whether physiological or emotional, increase their breathing rate and breathe more than they need to. He spent five decades studying the impact of breathing on numerous ailments and through his methodical and meticulous scientific research Dr. Buteyko concluded that healthy breathing, without any other intervention, was curative for over 100 diseases.

Dr Buteyko made a simple observation that so many who preceded him failed to notice. For example, it is common knowledge that when asthmatics have an attack, their breathing is laboured, there is excessive mucous production, the muscles in their airways constrict, and the cells lining their bronchotubes swell, making it difficult for them to breathe. It goes unnoticed that asthmatics might be compensating for their lack of air sensations by breathing very fast.  In fact, asthmatics often will have a respiratory rate 2 to 3 times faster than normal. It is this observation that led Dr Buteyko to make his pivotal discovery — asthmatics breathe more than they need to and it is the biochemical changes in the body that result in asthmatic symptoms.

Breathing too much was the cause of asthma, according to Dr Buteyko. Breathing too fast is also known as hyperventilation. When people hyperventilate, they are breathing very fast. A healthy breathing pattern is a person breathing 8 to 12 breaths per minute. If we breathe more than this, we are probably breathing more than we need to.

Buteyko Breathing

The science that supports the notion that we are "breathing too much" is mired in common suppositions held by all that oxygen is precious. There is the general perception that we can't possibly breathe in enough air. As Buteyko pointed out, "the theory of deep breathing disease is based on the principles of physiology. However, our opponents holding higher positions in our medicine, are still not able to grasp the fundamental idea stating that deep breathing causes hypoxia". After all, oxygen is the bearer of life and carbon dioxide is a waste gas. Nothing could be further from the truth. In 1905, scientist J.B.S. Haldane discovered that carbon dioxide levels actually determine how we breathe.

Dr. Buteyko used a physiological precept called the Bohr Effect, which was discovered in the 19th century. The Bohr Effect illustrated the erroneous mindset that breathing more was ok. The Bohr Effect describes the relationship of hemoglobin and oxygen. Hemoglobin transports oxygen
throughout our bodies to all the cells. When carbon dioxide levels fall below a certain threshold, then hemoglobin interprets the low carbon dioxide as a sign that it needs to hold onto the oxygen that it is carrying. Thus, even though there is lots of oxygen in our bodies, the cells do not get
access to it. Consequently, we take in a deeper breath or increase our breathing which instead of alleviating the symptoms of breathlessness, aggravates and increases the bond between hemoglobin and oxygen. When the brain does not get oxygen, it panics and irritability presides.

Asthmatics will visit their family doctor or pulmonary specialist and rarely be instructed on how to improve their breathing. Breathing exercises seem too banal for mainstream medicine. Dr Buteyko taught his breathing exercises to asthmatics and they improved without the need for reliever medications or steroids. Those with asthma who practice the Buteyko method experience
sustained and immediate relief from their symptoms.

Since respiration affects every cell of our body, breathing correctly brings tremendous health benefits. Asthmatics and those with COPD and other conditions such as angina, anxiety, and panic disorders know only too well the panic and terror when they can't breathe, so they breathe faster. For those who experience stress, sleep apnea, snoring, anxiety, and headaches, changing their breathing to a healthy pattern will bring them into balance and back to health. The first step to improving our breathing is to develop awareness of how we breathe. Are you breathing with your nose or mouth, with your chest muscles or diaphragm? Watch how people around you breathe and you will be surprised that many primarily use their mouth. By breathing with your nose and thus reducing over breathing, you are taking a first key step toward respiratory health and positively impact your stress levels.

The Quick Breath Test

1. When you take a deep breath, do you inflate your chest?
   2. Do you tire easily or wake up tired?
   3. Do you often feel that you are not getting full breath?
   4. Do you feel short of breath or breathless?
   5. Do you sigh often?
   6. Is your breathing mostly in your chest?
   7. Do you breathe with your mouth?
   8. Are your muscles often tense or sore to the touch?
   9. Do you experience queasy sensations in chest or stomach?
   10. Do you have excessive nasal mucus on waking?
   11. Do you snore and have problems with your sleep?
   12. Do you experience anxiety out of the blue?
   13. Do you suffer from headaches and mental fatigue?
   
   Ineffective breathing can cause all of these symptoms. All of them can disappear as you learn to restore your breathing to a healthy pattern. If you answered yes to any of these questions, you can gain significant benefits from learning the Buteyko Breathing Method.

Sussanna Czeranko, is a licensed ND in Saskatchewan.  Practicing since 1994, she has developed an extensive armamentarium of naturopathic tools and techniques for her patients.  Especially interested in balneotherapy, botanical medicine, breathing and nutrition, she is a frequent presenter and workshop leader. As the Curator of the Rare Books Collection at National University of Natural Medicine, she completed a twelve book series entitled In Their Own Words.  Sussanna is the founder of The Breathing Academy, a training institute for naturopaths to incorporate a scientific model of breathing therapy called Buteyko into their practice.  She currently lives and practices at her new medical spa located in Manitou Beach, Saskatchewan, Canada.

References:

• Eisenberg, D.M., Davis, R.B., Ettner, S.L., Appel, S., Wilkey, S., Van Rompay, M., & Kessler, R.   (1998).  Trends in alternative medicine use in the United States, 1990-1997.  JAMA.  280 (18), 1569-1575.

• Frolov, Vladimir, ³Endogenous Respiration, Medicine from the Third Millenium², Dinamika Ltd, Novosibirsk, Russia, 2000.

• Stalmatski, Alexander, ³Freedom from Asthma, the natural way to relieve asthma permanently², Kyle Cathie Limited, London, 1997.

Breathe 2022: Virtual Conference in Hawaii 

By Janet Winter

A review of select presentations from the conference (postponed from 2020 due to COVID)

OVERALL:  There was a wide range of interesting talks at this conference but for now I will focus on COVID, especially Long COVID as that is what many Buteyko educators are likely to encounter. 

One of the organisers, Dr Rosalba Courtney, had acute COVID during the meeting and shared with us that she was getting some relief with humming on the outbreath, pausing for a count of 4 before breathing in the resultant higher (presumably as humming is known to increase NO levels in the sinuses) levels of Nitric oxide that may be anti viral.

WHO definition of long COVID:
Post COVID-19 condition is defined as the’ illness that occurs in people who have a history of probable or confirmed SARS-CoV-2 infection; usually within three months from the onset of COVID-19, with symptoms and effects that last for at least two months.’ The symptoms and effects of post COVID-19 condition cannot be explained by an alternative diagnosis.

(Several of the speakers prefer the 4 week point for the definition of Long COVID).

Speaker:  Umakanth Katwa (Pediatric pulmonologist and sleep medicine Boston Children’s hospital).

This presenter gave a great presentation on COVID and said that even though children are unlikely to get it severely, you can get occasional atypical presentations. Acute COVID can give bronchitis, interstitial pneumonia, ARDS (acute respiratory distress syndrome) and sepsis with multi organ failure (MIS-C or multisystem inflammatory syndrome in children) which can be fatal. Heart failure is common as is a characteristic rash.

Dr. Katwa said that long COVID should be suspected If symptoms persist for over four weeks, with the patient testing negative for COVID for at least a week.

Symptoms:Fatigue (53%), Shortness of breath (43%), Joint pain (27%), Poor exercise tolerance dizziness, headaches, brain fog, chest pain, trouble speaking, muscle aches, loss of sense of smell, anxiety or depression POTS (postural orthostatic tachycardia syndrome) and insomnia.

From his earlier studies Dr. Katwa said the incidence is 30- 90% of children having Long COVID at six months after the acute infection and the pathophysiology is an enigma.

Risk factors for long COVID include: Obesity, cardiac conditions, inflammatory disorders, age. It's unclear if there's a genetic susceptibility and it can affect anyone, they may not necessarily have had severe COVID acutely.

The most common Long COVID/ long term respiratory symptoms are: shortness of breath (most common), persistent cough, sleep hypoxemia (especially in those with severe lung involvement), tachypnea, exercise intolerance and hyperventilation. 

Dr. KIatwa quoted from a paper by Motiejunaite et al (from January 2021, Frontiers in Physiology) that suggested hyperventilation could be a possible explanation for long lasting exercise intolerance in mild COVID survivors.

He speculated on the origin of the hyperventilation:  Hyperactivity of activator systems, or failure of inhibitory systems 

Consequences of alveolar hyperventilation are well known, most importantly a decrease in depolarization threshold of cell membranes that is to become “sensitised). 

Neuronal hyperexcitability, imbalance in the autonomic nervous system.

The hyperventilation in long COVID can be at baseline or intermittent or just occur with exercise. Hyperventilation induced hypocapnia can cause a multitude of extremely disabling symptoms dyspnea chest tightness, tachycardia, chest pain fatigue dizziness and syncope (fainting) at exertion, Hypocapnia due to the Bohr effect, less oxygen released to tissues. 

Hyperventilation syndrome in Long COVID and anxiety, breathing dysregulation may contribute to anxiety attacks in teenagers following COVID. It's commonly seen in children and teenagers with anxiety and panic. Evaluating breathing retraining is critically important in management of these young patients with minimal or no medications. 

POTS/ orthostatic intolerance/orthostatic hypotension prevalence: 10-40% post COVID mechanisms of POTS in COVID hypovolemia could include, fever, loss of appetite and decreased food fluid intake, cardiac deconditioning, blood pooling, autoimmunity, cytokine storm, inflammation chronic neural dysregulation, auto antibodies interact with autonomic ganglion. 75% of patients with POTS positive for anti-acetylcholine receptor antibodies that could respond to immunotherapy.

Breathing rehabilitation in long COVID, 3 publications:
In patients with long COVID, exercise capacity, functional status, dyspnea, fatigue and quality of life improved after six weeks of personalised interdisciplinary pulmonary rehab (Respiration February 2022).

Pulmonary rehabilitation is a feasible safe and effective therapeutic option in COVID-19 patients independent of disease severity (ERJ Open res 2021).

 Hyperventilation and symptoms of long COVID can be treated with breathing retraining and rehabilitation.

Summary:

• Long COVID symptoms are predominantly associated with breathing  dysregulation. 
• Hyperventilation is most common breathing problem but this is usually not suspected or tested in patients
• Breathing retraining is an important part of management of long COVID syndrome

__________________________________________________________

Speaker:  Dr. Todd Davenport (Professor of P.T, an expert in chronic fatigue or myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS) presented a case study of a woman with “deconditioning.” The client had been sick with the respiratory virus but not hospitalised: this occurred during 2020 so it couldn't be confirmed as COVID. She recovered to 75% fitness for three months and then she decided to do a hard workout to kickstart her recovery and she got brain fog fever and shortness of breath for three days -this is PEM (post exertional malaise.) It's very typical of ME/CSF and very common in long COVID. And it's not just fatigue, it's more than just tired.Mr Davenport described that with long COVID, PEM and fatigue can increase with time even when some of the respiratory symptoms are getting less. Although shortness of breath tends to persist, pulmonary rehab can cause “crashes” “and PEM by exceeding the patient’s aerobic threshold. In both Long COVID and chronic fatigue syndrome, you can find PEM and impaired systemic oxygen extraction (possibly related to hyperventilation?)

___________________________________________________________

Speaker:  Samantha Holtzhausen, M and Jessica DeMars, physiotherapists who specialise in pulmonary rehabilitation reported on success stories in Long COVID. Main point: physical therapists working with people with Long COVID should measure and validate the patient's experience. Post exertional symptom exacerbation (PESE) or PEM (post exertional malaise) must be considered, and rehabilitation needs to be carefully designed based on individual presentation. Beneficial interventions might first ensure symptom stabilisation via pacing, a self-management strategy for the activity that helps minimise PEM.

No inspiratory muscle training is recommended if the patient is unstable: normalise breathing first and watch out for PEM or you could “crash them” with breathing exercises. 

 Breathing retraining helps with some symptoms but is not the “cure-all”.

_________________________________________________________

Speaker:  Dr James Hull PhD, FRCP, FACSM spoke on COVID in athletes

Catching acute COVID- Professional athletes and regular serious exercisers are less likely to be hospitalised with acute COVID.  Risk factor for “couch potatoes” as big as those with poorly controlled diabetes! (data from ZOE study) ~9%

Long COVID is a big deal for athletes to have symptoms that stop them competing or training for >4 weeks. 1 in 4 not ready after common viruses,  only 1-20.

Actually similar chances as the general population of athletes getting Long COVID, symptom burden and pattern similar.

Dr. Hull divided the breathing problems into 1) EILO, exercise-induced laryngeal spasm, 2) EIB, exercise-induced bronchospasm-after peak exercise (asthma, beta agonists effective), 3) BPD, breathing pattern disorder

Lower respiratory symptoms are a big problem in returning to sport (above neck symptom, loss of sense of smell, stuffy nose not too bad).

Common symptom affecting athletic performance: SOB (shortness of breath) 58%

Long COVID clinic

1. Unexplained fatigue
2. Inappropriately high heart rate in response to exercise
3. Can’t catch a breath (disproportionate breathlessness).

Tidal volume is erratic and high, inefficient breathing.

Coaches must not push athletes too hard when returning them to post long COVID fitness.

__________________________________________________________

BBEA Member, Hadas Golan, MS CCC-SLP, Level 4 trainer, presented on  Current airway and breathing issues in speech, voice therapy and cough 

Summary
Take home, mounting evidence that breathing retraining can help with many symptoms of Long COVID, but care must be taken not to push too hard but to pace. Even reducing breathing can cause crashes, and best to avoid cueing “air hunger” initially. 

For more information, Breathe 2022  https://breathe2022.com/  

AN ASIDE:  This is a presentation (not from Breathe 2022) from a Buteyko trained specialist, Viklki Jones, who had long COVID herself may be useful.  Vikki also shared a case study working with a client with Long COIVD. 

https://us02web.zoom.us/rec/play/MVCjkE6hnZO6ko9lk2qKYoV2E68f2Zos-3b8VF7MsAxePRohlwaYtpxFaLK48eMJY8z5IX-4tc515tmq.M9DF9kixFSr7IjNh?startTime=1649865724000&_x_zm_rtaid=OyVWWfY8TL-8NMqSXCWRCg.1652874691949.d9dc820c0aa1b7ab4ae36d9a0ab32fc7&_x_zm_rhtaid=681

In for the Long Haul - Zoom    

Janet Winter: info@breathingremedies.co.uk 

The Humming Effect, Sound Healing for Health and Happiness

by Jonathan and Andi Goldman

BOOK REVIEW
By Carol Baglia, RRT, AE-C, BBET

One of my clients recommended this book to me.  I wanted to learn more about humming since I had been teaching it routinely for years as part of breathing retraining and my client seemed to know more about it than I did.  The authors claim that this is the first book on the subject and was published in 2017, ISBN 9781620554845.  The well-credentialed writers claim that “Humming many be one of the most powerful natural abilities that we possess.”

Everyone can hum and experience the extraordinary benefits that can result from their own self-created sound.  Humming is simply sound vibrations so the book starts with explaining how and why sound can heal.  Humming can act as an internal sonic massage.  Humming induces parasympathetic dominance with the Vagus nerve.  I knew of the benefits of sound vibration for moving mucus and nitric oxide production but learned that there is a much longer list of therapeutic effects such as increased lymphatic circulation, increased levels of melatonin, the release of endorphins, release of oxytocin, reduced levels of stress hormones, plus more.

The recommendations in this book were spot on aligning with Buteyko teachings such as sitting posture, diaphragmatic breathing, nasal breathing, doing humming in 5-minute sessions, and relaxation.  I was thankful to find this information that enhanced what I was teaching without contradictions.

The authors provide a link to online recordings of vocal examples for some of the exercises they present.  The one that I liked the most was the Constant Hum which was a recording of many people humming simultaneously so that it sounded like a beehive and you could hum along or just listen and let the sound waves work.

You can’t hum if your nose is blocked.  Try it.  In fact, not only must your nose and sinus cavity be open in order to hum most effectively, it is considered necessary by most vocal experts to have your mouth closed as well.  If you open your mouth as you hum, the volume of the sound you are making increases, but the feeling of the sound vibrating fades.  Sound does not have to be loud to create resonance or vibration.

I learned that making noise that is comfortable for that person is what is best.  Hum in a manner that suits you.  I wasn’t in the habit of blocking my ears with the humming but understand this to be a mudra in yoga practices.  I liked the way it intensified the feeling of vibration.  One suggestion was to gently block each ear by pressing on the cartilage at the ear opening.

I found this book to be a quick read and great addition to my Buteyko practice and library.  I hope you do too.

WE’RE IN THE MIDDLE OF A PANDEMIC!!

By Doris M. Waite, RDH, COMT

 
Not the Covid-19 virus and all its variants but something we’ve been unknowingly doing to our children. First, there are over 1 BILLION people in the world with Obstructive Sleep Apnea (OSA). How did that happen?  Well, it’s a sad story..... but let’s start at the beginning.

At the beginning of the Industrial Revolution, many people moved to cities to be closer to jobs.  They weren’t growing their own food anymore and eating it but began to eat foods that were packaged and eventually processed for “easy” consumption.  This change occurred over 150 to 200 years and in that time, we developed some really bad habits!
By the middle of the Twentieth Century, there was so much packaging and processing going on that it was chic to buy your food in the grocery store rather than making it at home (typical for mid 50’s: aww, can’t we have store bought cookies??).

People looking to make money during the baby boom, developed formula and Pablum for easy consumption and advertised it as being “the best” for baby.  They even gave doctors and hospitals free samples of formula for distribution to new mothers “just in case”.  Just in case.....mom couldn’t breastfeed.  So if moms had trouble breastfeeding, they could just switch to a bottle - no problem.

But there was a problem that most people don’t know about.  Babies who are bottle fed often become mouth breathers because their tongue is being pushed down to eat and feels “comfortable” on the floor of the mouth.  Mouth breathing leads to nasal congestion which leads to more mouth breathing and the cycle continues.  In addition, mushed up baby food was (and still is!) being marketed as “best for baby”, even selling “Junior” foods that were not quite as liquefied.  Babies were not developing chewing muscles and their tongues were not being challenged to function AT ALL!

So what does this have to do with OSA?  It just so happens that development of the muscles in the mouth, cheeks, lips and throat are strengthened by breastfeeding and chewing on solid, challenging foods.  When the tongue and the muscles at the back of the throat are toned, the tongue stays in the mouth where it belongs and doesn’t fall into the back of the throat to block the airway.  A blocked airway is what causes OSA.

On a trip to Tanzania a few years ago, I noticed that EVERYONE had beautiful, wide arches and straight teeth.  The reason: moms breast fed their babies and weaned to table foods - no bottles, no formula, no baby food.  (there isn’t one orthodontist there either!)

The question now is: how do we prevent our children and grandchildren from suffering from OSA?  Well, you could move to Africa or breastfeed and wean to open cup, have children choose their own food (Baby Led Weaning) and full time nose breathing.

Babies who are unable to nose breathe need to have their noses rinsed out daily until they CAN nose breathe.  If it is a physical obstruction, fix it and get that little one nose breathing.  Snoring babies are NOT cute.  By age 5, 70% of a child’s face has grown so early intervention is imperative.

If you know of a little one who could benefit from early intervention, find an Orthotropic dentist who can assist with facial growth and development early.  The child will not “grow out of it” but will become a problem adult.

Doris Waite is a Registered Dental Hygienist, Certified Orofacial Myofunctional Therapist and Buteyko Breathing Educator.

What gets you thinking?

When research in one area changes your treatment in another.

By Dale Gregore

Jung J-Y, Kang C-K. Investigation on the Effect of Oral Breathing on Cognitive Activity Using Functional Brain Imaging. Healthcare. 2021; 9(6):645. https://doi.org/10.3390/healthcare9060645

Reading the journal article referenced in this text made me think just as all research articles intend.  But here, the link with breathing and brain function/ cognition flashed in neon lights, reminding me again of the brain-breath connection.

We have all had the experience of reading an article and not resonating with the message or results at that moment.  However, at a different time or instance, re-reading that same article and really understanding the research principles, outcome and applications.  Whether it was timing or situational, this article popped out in my mind and made me think more about the need to be aware and even address breathing when working on memory with a patient.

Often in Speech Pathology, breathing is addressed when working on voice, swallow, and functional respiration during Activities of Daily Living (ADL.) Therapist may also work with patients on attention, information processing, comprehension, integration and higher-level cognitive functions such as working memory.  Those activities or therapy tasks are generally separate from voice, swallow, breathing.  After reading this article, I questioned…. should we incorporate breathing more into cognitive work?  Should we first address oral versus nasal breathing at rest and during a cognitive task?  Should we introduce nose clearing techniques and establish nasal breathing before starting on the memory task?  Hmmmmm, interesting!  This made me think and even discuss this and other research with my team of speech language therapists.  Things to be mindful of and to address; to note patient performance with oral versus nasal breathing……..was there a difference in pt progress or goal attainment?  Can nasal breathing be used as a memory task as well?  If we can habituate nasal breathing, we could facilitate significant changes physiologically and promote brain function that has increased learning potential.

The article Investigation on the Effect of Oral Breathing on Cognitive Activity Using Functional Brain Imaging, “investigated the effect of oral breathing on functional brain activity. It was confirmed that the functional connection decreased significantly during a working memory task in oral breathing rather than nasal breathing. Furthermore, the functional connections of the left cerebellum, and left and right inferior parietal gyrus appeared only during nasal breathing, but not during oral breathing. According to these results, oral breathing can interfere with the efficient performance of working memory. Therefore, brain areas closely related to working memory function were less active during oral breathing, suggesting that prolonged oral breathing could significantly induce impaired cognitive function together with various well-known side effects on the body. These findings also suggest that any solutions for oral breathing should be considered not only for dental care but also for working memory activity.”

What research gets YOU thinking? How has research in one area impacted your treatment in another? Things to think about…..

Dale Gregore
Level 1 Buteyko Educator, medical speech language pathologist with >35 years’ experience; board certification in swallowing; department/ program manager and adjunct professor.

Climate Action – 10 things to make your home air safe

By Robert Litman

The editorials in the media call for much needed climate action. On a more immediate personal level it is time to prepare the air in our homes to best support staying healthy and sustaining health during difficult weather, pollution, viruses, bacteria, and fire conditions. Having clean air to breathe is now a serious issue.  The atmosphere in our homes can be managed for optimal breathing health. Without taking preventive steps the inside air can be as filled with smoke and pollution as the outside air even if you have your windows closed. Smoke seeps through crack and older poorly sealed windows. Being prepared now for possible futures of wildfires and deterioration of atmospheric conditions due to fossil fuel emissions will prevent the scramble for these items and finding them sold out. Some of these items are unfortunately already in short supply.

The more immediate way to refer to climate change is to realize that we are dealing with changes to our atmosphere, Atmospheric Change.  The air we share with the entire population of the planet is in danger. 91% of the world’s population does not have a steady daily supply of clean air. Close to 9 million a year die from air pollution. Respiratory illness and heart attacks and strokes prevail as the major cause of death.  Breathing polluted air steadily for several days will cause damaging inflammation. This is especially true for those who already have compromised immune systems, the elderly, pets, and children.  Air quality on Vashon can be poor for a few hours in the morning as the trucks arrive bringing food and other supplies. With air quality in the United States deteriorating for the first time since the Clean Air Act in 1967 we must be prepared now. Below I have listed some things to do. Some research is needed to get the equipment best suited to your needs and financial abilities.

Each home needs to have on hand:

1. A good Air Quality Monitor to measure the inside air (inside air can be 2 to 3 times more polluted than the outside air) and know what kind of air you are breathing. This will guide you in implementing steps to improve the air quality if needed. Also to keep track of the results of the other air quality improvements being made. The monitor needs to have a reading for Carbon Dioxide levels. When there is smoke outside and we close all the windows, CO2 levels can rise quickly making one groggy and create a loss of cognitive abilities. Standards for co2 are online.
2. An effective air purification setup to clean indoor air. To be effective the size of the air purifier must match the size of the room you are attempting to keep clean. Each purifier states the size of the room it will clean on the box. This is the CADR – Clean Air Delivery Rate. How many times will the air in the space be turned over per hour for the size of the room it is rated for. Decibel levels are also on the box so you will know if it will be too noisy for your comfort level. For HVAC systems an MERV 13 filter is necessary. Be sure your unit can handle that much filtration and not harm the motor.
3. For smoke, the air purifier must have an activated charcoal filter along with a HEPA or True HEPA filter. Most also have a prewash filter to save filter life
4. Air purifiers vary in price from under $100 up to $1000. Good reviews are available online
5. Making your own air purifier for under $40 can be accomplished with a box fan and a MERV 13 furnace filter. Adding an extra activated charcoal filter can be a good idea. There are many videos on YouTube on how to make these.
6. For smoke, masks need to have activated charcoal in them. Plain cotton masks do not filter smoke. Charcoal mask inserts are available for this purpose.
7. It is advised by the Environmental Protection Agency to set up a clean room in your home. This would be a room that has clean purified air with no openings that allow smoke from the outside to enter. Again, instructions are on the EPA website and YouTube on how to accomplish this. It must have fresh circulating air, one that provides heating and cooling.
8. A pulse oximeter to monitor saturation levels of oxygen in the blood when you are feeling breathless. These readings will tell you when it is urgent to get help.
9. What not to do when there is smoke in the air. No cooking in the house or outside. No vacuuming which creates dust in the air. When the smoke is bad, take a shower and wash pets when you come back inside, otherwise you carry the debris into the house. Keep children off the floor and away from smoke debris carried into the house. Nasal washes are a good idea too after being outside.
10. Nasal breathing only is a must if possible. Mouth breathing takes all the smoke and pollution directly into your lungs. Nasal breathing gives the nose a chance to filter and condition the air for the lungs.

Robert Litman – The Breathable Body Vashon – robert@thebreathablebody.com -206-707-1639 www.thebreathablebody.com

Post Hip Surgery Relief

Steve McGillen, Level 2 educator, Buteyko Educator since 2013.

My hip surgery(total replacement) booked for April 2020 took a cancellation due to Covid until October 7, 2020.  I'd kept myself busy but with 100 metre walking tolerances, I was sedentary, retired and used control pauses for pain.

The rosy picture painted by the surgeon and the physiotherapist was excellent marketing and the epidural does last into the second day for full pain relief. However, don't kid yourself, Day 2-4, I felt like I had been hit by a truck. I could not lift my leg and needed assistance to even move my legs in and out of bed and to navigate a two wheel walker? at a tortoise pace. I was bruised and black and blue from hip to the knee. Yes, I looked forward to my 5 ice packs a day and naps. But by day 4, I needed a schedule. I craved some order from this open...do what you feel or do what physically you can do...and get up every 2 hours and do your exercises..

The physio mantra...do your exercises...15 min..@3 times a day.......ok? ok.  It was easy on the morphine.   

So, I grabbed my Buteyko Workbook and did a foundation set after every ice pack session.  The benefit was there. The comfort in the calm.  The quiet in my breathing. I gained a stronger ability to focus and some control. The morphine for me addressed the pain but the brain fog, wow...Doing a set provided clear simple work. The joy of being on task was refreshing as each day was unpredictable. It was a guess as to which leg part would work or hurt and to MacGyver a solution with the home options of: heat, cold, massage, naps, medication, water, food and yes, breathing .  

In closing, it's been three weeks with improvement and I've now graduated to a 4 wheel walker. My daily 5 foundation sets are my comfort, my efficacy and my friend.  As for Covid, I'm into 4 weeks isolation as a patient with no visitors. I honestly have not watched TV.   I technically know the body’s immune system but in reality, it's a wonder how it works.  I still use my back-up systems: hoping, praying, dreaming and laughter.  Well, it's been a necessary but frightening, humbling experience. My titanium hip is in, structurally sound to date and I can set some new goals.  I am grateful.

Lifestyle Medicine 

By Arend Hoiting - L5 Buteyko Educator and Trainer  

It is well known that medical intervention in the Western world consists mainly of medications, which are often prescribed in unbridled quantity. Increasingly, the numerous side effects of medication are perceived as infuriating and dangerous, and people in turn start looking for alternatives, for example in complementary medicine such as the Buteyko method. The many doctors I have had as clients have told me that they were never taught about breathing as a medical notion during their medical training. This is further supported by medical students when you ask them what they are studying. The answer is almost always: “I study medicine”. The emphasis is thus on “curing” by use of medication.

It is remarkable, and I think even unique that a large number of medical specialists from university medical centres in the Netherlands have partnered with the very well-known Dutch TNO organisation in The Hague. The TNO is the Netherlands Organisation for Applied Scientific Research. The TNO connects people and knowledge to create innovations that strengthen the competitiveness of companies and the well-being of people in a sustainable way. The TNO focuses on nine main areas, among others, Construction, Infrastructure and Maritime, Environment, Energy, Information and Communication Technology, Healthy Living, Industry, Strategic Analysis and Policy.  

A large group of medical specialists have united themselves in the organisation “Lifestyle4Health” and they describe the lifestyle as: “The whole package of nutrition, exercise, relaxation, sleep, reduction of exposure to toxic substances, and psychosocial support is of great importance to be and stay healthy. The fact that lifestyle interventions can be used for the recovery or treatment of disorders is less well known, even though several studies have been suggesting this for some time.” In summary, medical specialists in the Netherlands see lifestyle medicine as the research into the application of lifestyle interventions in curative healthcare as part of the medical treatment of diseases. 

Personally, I believe the core idea of scientists should be curiosity and I therefore got in touch with the initiator of the Lifestyle4Health organisation Prof. Dr. Hanno Pijl, endocrinologist at the Leiden Medical Centre (lumc). I pointed out to him the application of the Buteyko method in healthcare and indicated to him that Buteyko Specialists are also advocates of an integrated approach, such as Misha Sakharoff has been doing for years in his work with people with cancer. I am also personally in favour of supporting clients with regards to the psychological components of trust and anxiety which relate to each other as two communicative vessels. A stress reduction system such as mindfulness (Misha calls this 1-p attention) should also be addressed. It is not only about normal breathing when in a rest state, or only about exercise, nor is it only about having a better diet, or just reducing stress. The guidance should be an integrated approach which deals with all facets. This is also the promising approach of the Lifestyle4Health organization. I would almost call it a revolutionary approach, a turning point in thinking among medical specialists.  

Disappointing is the lack within this group when it comes to normal breathing in rest, a consistent breathing through the nose while at rest, on the move, and while speaking. Hanno Pijl’s response was disappointing and short: “I am only interested in scientific evidence for the Buteyko method”. He was also not sensitive to the argument that breathing is at the beginning of all life processes: the metabolism, the immune system, the endocrine system, and the central nervous system. Sadly, we often see that medical specialists are normative. They fully adhere to the standard of scientific research as something which is either true or false, for example by starting scientific research using an experimental and control group. I confronted him with the many clients that have been cured of heart diseases, COPD, and other disorders, and I still have the habit of calling clients after several years to find out whether they are still free of complaints and medication. I often hear from medical specialists that people like to refer this to the category of “spontaneous cures”.

Nevertheless, I am convinced that we should welcome this medical initiative in the Netherlands.

Arend Hoiting
Buteyko Specialist
Buteyko Noord Nederland
Ter Borch 16
9492 RB Zuidlaren
T : 050-4093448
M: 06-52450946
www.buteykonoordnederland.nl
a.e.hoiting@xs4all.nl

Lid Vereniging van Buteyko Therapeuten (V.B.T.)
Member of the Buteyko Breathing Educators Association (MBBEA) L5 Buteyko Educator and Trainer
Member (fellow) of the Buteyko Professionals International  (BPI)

Buteyko Breathing, Abdominal or Diaphragmatic?

Written by: Janet Winter, U.K. - Level 3 Buteyko Educator

First Published in an earlier version of Breath Notes

I recently noted that some Buteyko practitioners talk about abdominal (belly) breathing and some talk about diaphragmatic breathing. So I was asked to explain the difference! I am sure that we are all in agreement that the predominantly chest breathing pattern with which many of our clients start off needs to be discouraged, and relaxed breathing—low and slow—promoted.

But when it comes to belly or diaphragm, belly breathing could be rather unrelaxed, holding the rib cage stiff and pumping in and out of the abdomen. I am a relative newcomer as I have only been a Buteyko practitioner for a couple of years, and some of you are breathing experts, but I thought I would just share 2 descriptions of good breathing that I have found very useful.

The first is from a British choir master, as seen on TV http://www.garethmalone.com/sing/tips (click on the “breathing” tab) and is very short and sweet. For getting air into the bottom of the lungs for good singing his tip is: “Imagine you have a rubber ring around your waist (your diaphragm). The trick is to try and push the imaginary rubber ring outwards with your body.”

This seemed to explain what we want simply and clearly, I always tell this now to my clients. The rib cage has to expand and the diaphragm must contract if you follow these instructions.

The second is from an excellent site from an Alexander Technique teacher, (Philip Pawley, died January 2012) also in the UK. I know that some AT teachers call abdominal breathing “abominable breathing!” This one goes into lots of interesting detail. I often recommend to my clients that they look into AT to learn more about breathing, after they have learned initial control, and increased their control pause with Buteyko.

There are three main kinds of breathing:

•  Chest Breathing
•  Belly Breathing (unsupported diaphragm)
•  Diaphragmatic Breathing (properly supported)

Chest Breathing

Breathing with the upper chest is the most effortful and least productive of the three. The chest and neck muscles lift the breast-bone and upper ribs. As the breast-bone comes up, it also comes forward.

This inflates the upper lobes of the lungs. Because they are small, only a small volume of air is drawn in. This means rapid, short breaths. The effort involved is considerable. It is also a drag on the head, neck and shoulders so that these have to be braced in order to provide an Archimedean point from which the upper chest can be lifted.

This type of breathing is characteristic of anyone who is struggling for breath.

The Diaphragm

When the dome-shaped diaphragm muscle tightens to draw air into the lungs, it flattens. This can happen in one of two ways:

1. the top of the dome comes down but its edges are fixed, (un-supported diaphragmatic breathing)
2. the dome also lifts the ribs as its edges come up. (supported diaphragmatic breathing)

Belly Breathing (unsupported diaphragm)

This is usual but not very effective. The lower ribs don’t move much. This is for two reasons. Firstly, because the diaphragm isn’t lifting them. Secondly, because over-tight muscles are stopping the ribs from moving. Instead, the top of the dome, moving down, creates space for the lungs to expand into.

This method of breathing also pushes down on the abdominal organs. They have to go somewhere. As a result, they end up bellying out in front — a characteristic of unsupported diaphragmatic breathing. The fact that many people breathe in this way is the main reason why a ‘beer-belly’, or ‘middle-aged spread’, is so frequent even in people who are not over-weight, don’t drink beer and are not yet middle-aged!

This piston-like action is often believed to be the proper action of the diaphragm. In fact, it’s only one part of the story. The best use of the diaphragm is only possible when it is getting its proper support, as we shall now see.

Diaphragmatic Breathing (properly supported)

The dome-shaped diaphragm muscle is attached by its edges to the lowest ribs, the costal arch, the base of the breast-bone and (at the back) to the front of the lumbar spine.

In supported diaphragmatic breathing, because the abdominal organs are supported in place, the top of the diaphragm cannot come down as much as it does in unsupported diaphragmatic breathing. (We will look later at what provides this support).

This support provides the “Archimedean point” enabling the diaphragm to lift the lower ribs. (These lower ribs are the ones which join together in front to form the costal arch instead of attaching directly to the breast-bone).

The way these ribs are jointed to the spine means that, as they come up, they must also come out sideways (not forwards as the upper ribs do). To picture the movement of one of these ribs, imagine starting to lift the handle of a bucket from its rest position, where it lies against the side of the bucket; imagine lifting it up-and-out sideways. The movement of the rib is just like this. The result of all the lower ribs moving together in this way is a big sideways expansion: an expansion of one’s back just as much as it is an expansion of one’s lower chest. This inflates the large lower lobes of the lungs very considerably.

Since a very large volume of air flows in and out of the lungs, one naturally breathes much more slowly this way. This all makes for effortless breathing. Another advantage is that, while upper chest breathing creates a downward drag on the head and neck, this support for the diaphragm actually acts as a hydraulic lift, buoying one up and greatly reducing the effort of maintaining an erect posture.

Egyptian Trial Shows the The Buteyko Breathing Technique Improves Lung Function

By: Charles Florendo, MD, Cameroon

A recent trial conducted in Egypt and published at the Egyptian Journal of Chest Diseases and Tuberculosis shows that theButeyko Breathing Technique not only improves asthma control but can improve Peak Expiratory Flow Rates (PEFR) as well.

This is a welcome development as it is the first published study to record improvements in lung function among asthmatics subjects taking up the Buteyko Breathing Technique. The study had 40 participants, 20 of whom were taught the Buteyko Breathing Technique while another 20 only received medical management. The study followed up participants for 6 weeks which showed that PEFR improved by 51% in the Buteyko group as compared to only 3.6% in the control group. The Buteyko group also showed decreased daily symptoms by 52% as compared to only 0.8% in the control group.

Some other interesting notes done by the trial were that the researchers measured and recorded the participants control pauses (CP) as well. Participants in the Buteyko group had increased their CP by 69% compared to only 8% in the control group. Much like in previous studies, the Buteyko group also decreased their use of inhaled steroids by 33% compared to 15% in the control group.

The study did not mention who was the Buteyko Practitioner involved in the study. This is perhaps the first African study of the Buteyko breathing technique to be published. With it though comes the distinction that clinical studies on the Buteyko breathing technique have been completed and published from all five inhabited continents of the planet: America, Europe, Australia, Asia, and now Africa.

To search for the trial online, you may look for: Hassan, Riad, Ahmed. Effects of Buteyko Breathing Technique on patients with Bronchial asthma. Click HERE for link to Egyptian Journal of Chest Diseases and Tuberculosis (2012) 61, 235-241.

Nursing students in the Philippines prove that Buteyko is safe and effective for Kids

A group of nursing students from the University of Santo Tomas in the Philippines conducted a trial on the Buteyko Method involving children 7-11 years of age as part of their thesis. With assistance from Buteyko Practitioners Dr. Charles Edward Florendo, and Patrick McKeown, the students followed up 7 children who took up Buteyko, and 7 others who did not. All the children were diagnosed with asthma by a pediatrician. The children were assessed using the Filipino versions of the Pediatric Asthma Quality of Life Questionnaire, and the Asthma Control Questionnaire. They were followed up for 4 weeks. Children who took up Buteyko were taught the Buteyko Steps exercises as well as games promoting proper breathing. The Buteyko group noted significant improvements in both the quality of life and asthma control scores on the third and fourth weeks after their initial tuition. On the other hand, no significant difference were noted for children in the control group. The group who made the thesis received a good grade and were invited to present their paper in conferences in Singapore and Canada.

The nursing students are Romella C. Lina, Matthew Daniel V. Leysa, Zarah DF Libozada, Maria Francesca I. Liro, Angelo Liwag, Gabriel D. Ramos, and their thesis adviser is Margaret M. Natividad RN, M.Ed. Click HERE for a downloadable version of this thesis.